Histopathological correlation of endometrial samples in pre and postmenopausal women with abnormal uterine bleeding

Introduction: Abnormal Uterine Bleeding (AUB) is the most common clinical presentations in pre and postmenopausal women and is caused by various etiological factors ranging from inflammatory, benign to malignant lesions. The microscopical examination of the endometrium carries an important role in diagnosing various etiopathological factors in cases of AUB. Objectives: To know the spectrum of lesions of the endometrium with respect to age. To determine histopathological correlation of endometrial samples in pre and postmenopausal women. Materials and Methods: A cross sectional study was conducted from October 2009 to September 2011,involving 250 female patients, 40 years and above presenting with AUB. The patient's endometrial samples were collected by biopsy, D & C or hysterectomy. Results: The maximum incidence of AUB in premenopausal women were seen in 40-42 years age group (38.42%), while in postmenopausal women, highest incidence of AUB cases were seen in the age group of 50-52(43.3%). years In the present study there was a high association between histopathological spectrum of endometrial lesions and age. Proliferative pattern was the commonest endometrial profile in the age group of 50-54 years (30.31%), where as secretory pattern (30.29%) was common in the age group of 45-49 years, atrophic Endometrium (100%) is seen in the age group of 65-69 years, polyps (24.9%) in the age group of 60-64 years, endometritis (9.0%) in age group of 45-49 years, irregular shedding (21.6%) in the age group of 40-44 years, simple hyperplasia (19.6%) in the age group of 45-49 years, whereas endometrial adenocarcinoma was more frequent in the age group of 55-59 years (11.7%). In premenopausal women, the most common endometrial pattern was secretory (26.8%), while in postmenopausal women majority of the endometrial profiles were atrophic (41.7%). Conclusion: This study showed that other than normal physiological changes in both pre and postmenopausal women, various benign and malignant conditions also occurred with increasing frequency. There was high association between the various bleeding presentations and spectrum of endometrium lesions found. Hence, the symptom “abnormal uterine bleeding”, requires prompt attention with respect to the etiology whether physiological or pathological and cannot be ignored. Therefore, microscopic analysis of the endometrium must be considered in all elder women presenting with AUB.